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  • BDD Moderators: Keif’ Richards | negrogesic

Ethnobotanicals a warning against Ashwagandha and serotonin syndrome

Snafu in the Void

Moderator: NMI Bukowski Jr.
Staff member
Joined
May 27, 2020
Messages
32,055
The last month of my life has been a living nightmare...

About 10 weeks ago I started using ashwagandha. I found it to be surprisingly effective for stress relief and general anxiolysis, so I began taking it every day. I was using the recommended amount on the bottle which was 600mg of standardized 5% (KSM-66). The longer I used it, the more effective it became. Some of the alkaloids are fat soluble and take time to build up in the body.

It does quite a few things in the body, but namely in my case it raises serotonin levels. I typically do enough research before taking anything and I knew that it would do this, but sort of brushed it off because I'm quite confident with my ability to determine if a drug is having adverse consequences in my body. A whole month went by and I experienced no side effects or any negative things, only benefits, so at this point I mentally deemed it "Safe" or not very harmful. I also brushed off the warnings that it should be cycled and not taken for more than a few continuous weeks. I'm a drug nerd... I know what I'm doing... right?

After 4 weeks of use I started to notice myself becoming a little more stressed out than usual, minor agitation, but nothing alarming. My life isn't in a very good place right now and this is also very normal for me, so I brushed it off and also upped my dose from 600mg to 900mg. Over the next 2 weeks this stress and anxiety slowly got worse and worse. I started having some old schizophrenia symptoms (which I had mostly recovered from) starting to manifest again. This is also not unusual for me, stress brings out past symptoms, so I brushed it off and did not attempt to connect the symptoms to the ashwagandha.

After around 6 weeks of use I knew something was wrong. I was feeling oddly euphoric on top of stress, anxiety, fidgeting, and a very notable increase in hallucinations. This is where it gets fucked up... all of these symptoms I could easily explain as stress causing a resurgence in hallucinations and thus causing anxiety and agitation. It's not an out of the ballpark assessment, it would make sense as one possibility. However, it was the ashwagandha! It had built up so much serotonin in my system that I was actually entering SEROTONIN SYNDROME - which just happened to feel a lot like anxiety + schizophrenia. I had never had serotonin syndrome before so I was unfamiliar with it, and made the wrong assumption. My gut reaction was to up my dose even further to 1200mg! I could not see the obvious right in front of me that it was the supplement I was taking directly causing this, I had convinced myself that I was having another schiozphrenia episode... but I was dead wrong.

It got worse and worse over weeks 7 and 8. I then started entering a very dangerous level of serotonin syndrome. New symptoms appeared. Goosebumps, odd rushes of physical tingling, dizziness, increased heart rate, confusion, constantly sweating, more hallucinations, serious agitation, brain zaps, startling reactions to sound, etc... I was still very confused and now I wasn't thinking properly. I was so scared I tossed ALL substances I had in the trash, including the ashwagandha. It wasn't until the next day after I did not take the pills I made the correlation, but it was almost too late. At this point I was in pretty serious serotonin syndrome and it wasn't just casually high levels anymore.

I stopped the pills and started slowly getting better, but after 72 hours I went into WITHDRAWAL from these pills, after only taking them for 2 months. Nasty SSRI type withdrawal, complete crash, new symptoms, insomnia, totally fucked. I took 1 pill to level out and this threw me into another psychosis. I woke up in the middle of the night in complete psychosis. Scared shitless. AWFUL side effects.

The last 2 weeks has been a game of how much to take to stop withdrawals, but not too much to go back into serotonin syndrome and psychosis. Oddly just 15-20mg is enough to stop the withdrawal which is miniscule compared to my doses. It's likely an alkaloid built up in my system and it's taking FOREVER to get back to normal.

I am just now after a month of hell and careful tapering starting to feel somewhat normal again. I'm still having brain zaps and various symptoms, but I think I will be OK. I wonder how how much damage I've done to my brain. I am lost in a mental fog and my brain feels like it's recovering from a month long meth binge.

The awful part about this is I would have identified the ashwagandha as the problem immediately had I not experienced schizophrenia in the past. I kept misidentifying the symptoms as that.

I do still think this is a great supplement to take, but obviously in moderation. Do not take it for more than 2 weeks continuously, and do not take it if you are on an SSRI or other serotonin moderating drugs.

This just goes to show that even a drug nerd can make some very serious mistakes when using substances. I feel like an idiot that I let it get that bad, it could happen to anyone.

Stay safe BL
 
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The last month of my life has been a living nightmare...

About 10 weeks ago I started using ashwagandha. I found it to be surprisingly effective for stress relief and general anxiolysis, so I began taking it every day. I was using the recommended amount on the bottle which was 600mg of standardized 5% (KSM-66). The longer I used it, the more effective it became. Some of the alkaloids are fat soluble and take time to build up in the body.

It does quite a few things in the body, but namely in my case it raises serotonin levels. I typically do enough research before taking anything and I knew that it would do this, but sort of brushed it off because I'm quite confident with my ability to determine if a drug is having adverse consequences in my body. A whole month went by and I experienced no side effects or any negative things, only benefits, so at this point I mentally deemed it "Safe" or not very harmful. I also brushed off the warnings that it should be cycled and not taken for more than a few continuous weeks. I'm a drug nerd... I know what I'm doing... right?

After 4 weeks of use I started to notice myself becoming a little more stressed out than usual, minor agitation, but nothing alarming. My life isn't in a very good place right now and this is also very normal for me, so I brushed it off and also upped my dose from 600mg to 900mg. Over the next 2 weeks this stress and anxiety slowly got worse and worse. I started having some old schizophrenia symptoms (which I had mostly recovered from) starting to manifest again. This is also not unusual for me, stress brings out past symptoms, so I brushed it off and did not attempt to connect the symptoms to the ashwagandha.

After around 6 weeks of use I knew something was wrong. I was feeling oddly euphoric on top of stress, anxiety, fidgeting, and a very notable increase in hallucinations. This is where it gets fucked up... all of these symptoms I could easily explain as stress causing a resurgence in hallucinations and thus causing anxiety and agitation. It's not an out of the ballpark assessment, it would make sense as one possibility. However, it was the ashwagandha! It had built up so much serotonin in my system that I was actually entering SEROTONIN SYNDROME - which just happened to feel a lot like anxiety + schizophrenia. I had never had serotonin syndrome before so I was unfamiliar with it, and made the wrong assumption. My gut reaction was to up my dose even further to 1200mg! I could not see the obvious right in front of me that it was the supplement I was taking directly causing this, I had convinced myself that I was having another schiozphrenia episode... but I was dead wrong.

It got worse and worse over weeks 7 and 8. I then started entering a very dangerous level of serotonin syndrome. New symptoms appeared. Goosebumps, odd rushes of physical tingling, dizziness, increased heart rate, confusion, constantly sweating, more hallucinations, serious agitation, brain zaps, startling reactions to sound, etc... I was still very confused and now I wasn't thinking properly. I was so scared I tossed ALL substances I had in the trash, including the ashwagandha. It wasn't until the next day after I did not take the pills I made the correlation, but it was almost too late. At this point I was in pretty serious serotonin syndrome and it wasn't just casually high levels anymore.

I stopped the pills and started slowly getting better, but after 72 hours I went into WITHDRAWAL from these pills, after only taking them for 2 months. Nasty SSRI type withdrawal, complete crash, new symptoms, insomnia, totally fucked. I took 1 pill to level out and this threw me into another psychosis. I woke up in the middle of the night in complete psychosis. Scared shitless. AWFUL side effects.

The last 2 weeks has been a game of how much to take to stop withdrawals, but not too much to go back into serotonin syndrome and psychosis. Oddly just 15-20mg is enough to stop the withdrawal which is miniscule compared to my doses. It's likely an alkaloid built up in my system and it's taking FOREVER to get back to normal.

I am just now after a month of hell and careful tapering starting to feel somewhat normal again. I'm still having brain zaps and various symptoms, but I think I will be OK. I wonder how how much damage I've done to my brain. I am lost in a mental fog and my brain feels like it's recovering from a month long meth binge.

The awful part about this is I would have identified the ashwagandha as the problem immediately had I not experienced schizophrenia in the past. I kept misidentifying the symptoms as that.

I do still think this is a great supplement to take, but obviously in moderation. Do not take it for more than 2 weeks continuously, and do not take it if you are on an SSRI or other serotonin moderating drugs.

This just goes to show that even a drug nerd can make some very serious mistakes when using substances. I feel like an idiot that I let it get that bad, it could happen to anyone.

Stay safe BL
I’ve currently been taking ashwaganda, L tyrosine, Omega 3, 5htp, L citrulline, L theanine, GABA for a few months
 
Wow, I'm going to start skipping days instead of taking 800mg/day. I've felt nothing at all alarming, even with taking 45mg mirtazapine nightly. Thanks for the warning @Negentropic !!
yeah, it seemed quite benign for the first 6 weeks, then it just turned on me

there is something wrong with my serotonin system, how much that plays into this I'm not sure but I have a feeling it made me susceptible to this

however, the withdrawal effects I'm having are commonly reported and those are almost just as bad, they seem to start around 48-72 hours after last dose
 
yeah, it seemed quite benign for the first 6 weeks, then it just turned on me

there is something wrong with my serotonin system, how much that plays into this I'm not sure but I have a feeling it made me susceptible to this

however, the withdrawal effects I'm having are commonly reported and those are almost just as bad, they seem to start around 48-72 hours after last dose
I'm definitely going to taper off of it slowly, more withdrawal symptoms are the last thing I need. I'm about 4 weeks into taking it, so hopefully I can escape the hell you're experiencing. Does changing to taking it every other day for 2 weeks, then possibly stopping it at that point seen like reasonable precautions??
 
I'm definitely going to taper off of it slowly, more withdrawal symptoms are the last thing I need. I'm about 4 weeks into taking it, so hopefully I can escape the hell you're experiencing. Does changing to taking it every other day for 2 weeks, then possibly stopping it at that point seen like reasonable precautions??
yeah you're probably safe, honestly I would just stop now and see if you even get withdrawals if it's only been 4 weeks, it's not terribly bad mostly a headache, dizziness and brain zaps, but still bad enough to be distressing

are you taking KSM-66 or just ground root?
 
yeah you're probably safe, honestly I would just stop now and see if you even get withdrawals if it's only been 4 weeks, it's not terribly bad mostly a headache, dizziness and brain zaps, but still bad enough to be distressing

are you taking KSM-66 or just ground root?
Just ground root
 
Just ground root
You're probably ok. I forgot to mention I was actually taking more than I stated I guess.

My pills contain 300mg (5% standardized) + 200mg ground root. The standardized stuff is a lot stronger. I forgot to add the ground root in the doses above.

But I would still stop taking it and see how you feel after 3 days.
 
Good report, thanks for sharing.

I'd have to find the exact extract I was taking, but it gave me too much stimulation to be useful, with everytime leading to noteable increase in HR, BP, terrible insomnia, and occasional awful anxiety. No other noticeable benefit. Really couldn't find anyone who sort of echoed a similarily "bad" experience (even if your situation and use is definitely different than mine). It has to be the most lauded botanical supplement out there, so it's good to add some contrasting experiences.
 
Good report, thanks for sharing.

I'd have to find the exact extract I was taking, but it gave me too much stimulation to be useful, with everytime leading to noteable increase in HR, BP, terrible insomnia, and occasional awful anxiety. No other noticeable benefit. Really couldn't find anyone who sort of echoed a similarily "bad" experience (even if your situation and use is definitely different than mine). It has to be the most lauded botanical supplement out there, so it's good to add some contrasting experiences.
the only psychoactive effect is a certain drowsiness and anxiolysis, which I found to be quite effective, but takes a few days of dosing to show up when taken by itself

it also potentiates other GABAa agonists for sure, even on a first dose - first time I took it was on benzos and it was noticeable

that's not why people use it tho, nor is it a good reason to
 
After reading the OP again I think this might be my mystery illness, it's a possibility anyway. I'd be grateful to anyone who knows about this to comment.
I'm on fluoxetine, buprenorphine, gabapentin and nefopam with some codeine occassionally. So I googled SS and the tremors are a thing I've had often when I have my first vape of flower in the day. I vape a good gram a day, current strain is girl scout cookies much more stimulating than my usual indicas, I haven't slept in days, sweating buckets, agitated, vom & diahrrea, just like opiate withdrawal, except I know when I ought to get opiate withdrawal and this week wasn't one of those times, but I don't normally take tramadol and I had a couple of those, two exactly just before this mind frick began. I've had visual hallucinations which are unusual for me, I get audio hallucinations after too long on opiates, but I've been very moderate recently and most days just have kratom and flower with the above meds from the doctor.
I dunno, it's confusing and my brain is really fuzzy after being so ill the last few days. I thought maybe something I ate, but I was so overemotional it had to be drug related. I stopped nefopam and all other painkillers, had kratom again instead and magically I'm well. Kratom was another thought, maybe too often, got used to it then skipped a couple of days and got withdrawal from that? but other opiates didn't cure me quickly. confusing.
i just want to avoid the same thing happening again, it was really bad.
 
After reading the OP again I think this might be my mystery illness, it's a possibility anyway. I'd be grateful to anyone who knows about this to comment.
I'm on fluoxetine, buprenorphine, gabapentin and nefopam with some codeine occassionally. So I googled SS and the tremors are a thing I've had often when I have my first vape of flower in the day. I vape a good gram a day, current strain is girl scout cookies much more stimulating than my usual indicas, I haven't slept in days, sweating buckets, agitated, vom & diahrrea, just like opiate withdrawal, except I know when I ought to get opiate withdrawal and this week wasn't one of those times, but I don't normally take tramadol and I had a couple of those, two exactly just before this mind frick began. I've had visual hallucinations which are unusual for me, I get audio hallucinations after too long on opiates, but I've been very moderate recently and most days just have kratom and flower with the above meds from the doctor.
I dunno, it's confusing and my brain is really fuzzy after being so ill the last few days. I thought maybe something I ate, but I was so overemotional it had to be drug related. I stopped nefopam and all other painkillers, had kratom again instead and magically I'm well. Kratom was another thought, maybe too often, got used to it then skipped a couple of days and got withdrawal from that? but other opiates didn't cure me quickly. confusing.
i just want to avoid the same thing happening again, it was really bad.
That combo of drugs can certainly cause SS

My situation actually got worse after I posted this thread and ended up going to the hospital a few weeks later.

It got so bad that taking just 0.5g of kratom (my typical dose was 14g) caused extreme agitation, tachycardia, hypertension, dilated pupils, fever, tremors, confusion/delirium, diarrhea, hallucinations and insomnia. Awful and scary experience. (And those are considered MILD symptoms, it gets much worse)

Bupe and kratom can both cause SS especially combined with SSRI

You should definitely start lowering your doses of serotonergic drugs before it gets worse!
 
That combo of drugs can certainly cause SS

My situation actually got worse after I posted this thread and ended up going to the hospital a few weeks later.

It got so bad that taking just 0.5g of kratom (my typical dose was 14g) caused extreme agitation, tachycardia, hypertension, dilated pupils, fever, tremors, confusion/delirium, diarrhea, hallucinations and insomnia. Awful and scary experience. (And those are considered MILD symptoms, it gets much worse)

Bupe and kratom can both cause SS especially combined with SSRI

You should definitely start lowering your doses of serotonergic drugs before it gets worse!
I'm glad you posted the thread, I read it at the time and came back to look for it when the penny dropped that it might be SS, I'm not sure I would have thought of it otherwise. I'm having a bit of a detox this week and maybe stopping or skipping some fluoxetine too.
 
I'm not better, thought I was, then violently threw up everything I ate today. I would sleep for a week if I could sleep. I've a few temazepam so I'll take one tonight and stop kratom. I had 9g earlier, so it's not kratom withdrawal. One of the suspects off the list.
 
I've done the sensible thing and asked a doctor I trust not to blab my secrets. First time in my life I've been concerned enough to do that, not my own doctor, must tread carefully. I'll get a reply later, he's playing football now.
 
I'm so glad I did a quick taper and stopped taking this plant. I never got any worthwhile effects from it anyway.

Feel better @papercuts

Kratom generally does not cause SS by itself, other drugs do, but once it develops kratom WILL exacerbate it and makes it worse due to it being a serotonin antagonist. Just to clarify.

I've done the sensible thing and asked a doctor I trust not to blab my secrets. First time in my life I've been concerned enough to do that, not my own doctor, must tread carefully. I'll get a reply later, he's playing football now.

Yes, if you were to tell your prescribing doctor he would cut you off. The only real treatment for SS is discontinuation of the drugs causing it.

Benzos, serotonin blocking agents (a specific antihistamine) and antihypertensives temporarily treat the symptoms, but only removing the offending drug with solve the issue.

Good luck man, I hope you're reducing your intake (including your SSRI)! After my case continued to develop and got very bad I had to stop taking EVERYTHING including caffeine, cannabis, alcohol, etc.

The experience caused surprise when I learned just how many drugs increase serotonin levels. Even aspirin has an effect on serotonin! I became hypersensitive to it all.
 
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Kratom has some bad reactions with other drugs.even on your own takin a lot isn't good at my opinion.bupr.also have many reactions with other substances.even more some ssri....don't know,vut taking more than two different substances seems me a lot.SS for sure is frightening condition,which even could be fatal
 
after doing some research a few weeks ago the most common causes of SS are:

SSRI + Antipsychotic
SSRI + opioids (especially, but not limited to, fentanyl, tramadol, bupe)
SSRI + certain supplements (such as Black Seed Oil)
SSRI + alcohol as well (alcohol itself has an SSRI like effect and prevents the breakdown of serotonin)

and obviously the infamous SSRI + MDMA

also read a case of SSRI + meth + kratom causing it

even things like loperamide can cause SS, by itself in some cases (most commonly in older men). This is interesting because it doesn't cross the BBB, but it does release a lot of serotonin in the BODY - which then crosses the BBB!

in the majority of cases SSRI is involved, however, it definitely can occur without it
 
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Thanks for the list @Negentropic looking down it I didn't have fent or antipsychotics, the rest, yes I had all them in the last week. I ran out of road with asking the doctor because if I'd answered all his questions, he'd have been obliged to report me and that's not a situation I would put him in. I've stopped fluoxetine totally, it doesn't stop me being depressed anyway, just sugar coats it a little so I smile nicely and scare noone, lol.
I tried yesterday only bupre, then added gabapentin at the end of the excruciatingly long day for some sleep, didn't work. Don't like taking temazepam days in a row so had cannabis eventually and that eased some suffering but didn't help me sleep.
I weigh 47kg now, not a good look.
Yesterday was a day that felt like withdrawal again, so sick and weak and sweaty, bawling my eyes out and saying I wanted to die, all that.
Whatever it is, it's not bloody worth it when I don't even know what causing it so y'know, it can't have been memorable. I honestly can't see where I might have a drop in opiates unless it's the bupe/cannibis effect in daily tokers where the bupe builds up to much higher levels as the body prioritises removing thc instead. Then you don't vape flower for a day and the body seizes the opportunity to dump out as much bupe as possible while it has a break from thc clearing (not a scientific theory, just my theory from studies in another thread and my experiences of opiate type withdrawal every time I don't have flower).
It's a pain in the ass not being able to leave it down because it's harder to hide from the world with the smell seeping out.
Over time I thought my cannabis theory must be bunk, wouldn't people know? Yet here I am again in what seems to be an ever worsening withdrawal syndrome ... from bud? From serotonin? 🤷‍♀️
Maybe they don't know about it yet because the only people with both bupe and cannabis in them are as unwilling as me to admit it.
Some of you guys in non prohibition places could, but if weed were legal here then I wouldn't give a shit about it because it's only a problem without thc?
Sorry to have changed subject slightly, just didn't work it out last time either.
Fuck it, I need my pipe.
 
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